The use of endoscopes for diagnostic and therapeutic indications is rapidly expanding. To improve performance, endoscopes have been optimized to best accomplish their purpose. Accordingly, there are upper endoscopes for examination of the esophagus, stomach and duodenum; colonoscopes for examining the colon; angioscopes for examining blood vessels; bronchoscopes for examining the bronchi; laparoscopes for examining the peritoneal cavity; and arthroscopes for examining joint spaces. The discussion which follows will apply to all of these types of endoscopes.
Instruments to examine the rectum and sigmoid; known as flexible sigmoidoscopes, are good examples of the usefulness of endoscopic technology. These devices are expensive, and they are used in a contaminated environment for a fairly brief procedure. There has been a large increase in the use of "flexible sigmoidoscopes " for use in screening symptomatic and asymptotic patients for colon and rectal cancer. Ideally, flexible sigmoidoscopes must be used rapidly and inexpensively in order to maintain the cost of such screening at acceptable levels. In order to achieve the ability to perform multiple endoscopic examinations in a short time period, disposable endoscopic sheaths are used to completely isolate the long insertion tube of the endoscope from contaminated exterior environments encountered during an endoscopic procedure.
However, physicians, nurses, and other personnel have experienced significant difficulties installing and removing the sheaths without contaminating themselves, equipment, or the patient. This contamination often occurs because the insertion tube of an endoscope is typically long, up to two meters long for a sigmoidoscopes, and very flexible. After a sheathed insertion tube is removed from a patient upon completing a portion of an endoscopic procedure, the contaminated sheath and insertion tube combination tend to flop about and contaminate equipment and personnel, such that the physician or nurse often must grab the assembly to control it while removing the sheath. In addition, the sheaths must be protected from becoming contaminated prior to use or during installation onto the insertion tube so they do not contaminate or infect patients during endoscopy, particularly those having a depressed immune system.
To reduce the risk of contamination during installation or removal of the sheath, stands have been used to receive the sheath during the installation and removal process, as shown in U.S. Pat. No. 4,907,395. However, the stands do not provide a work surface that allows the physician to set needed equipment or components in a convenient location, or that will hold or contain fluids or other material often used or encountered during the sheath's installation or removal procedure. In addition, the stand does not actually hold the sheath during installation or removal, rather it is adapted to hold a bag having a flange thereon that contains or receives the sheath. Thus, the stand does not provide a device to positively secure or hold the sheath during installation or removal.
As a result of the above-described risks of contamination, the difficulties experienced in installing and removing sheaths by conventional techniques, and the limitations in sheath holding devices, there has not heretofore been acceptable solutions to the problems of positively securing or holding the sheath for quick and easy installation or removal of the sheath while avoiding contamination and while providing a convenient work surface and containment area near the secured sheath.